目的:调查季节性,流行病学特征,以及托斯卡纳放松COVID-19限制后RSV相关住院的临床严重程度变化,意大利,到2022-2023赛季。
方法:从2017年到2023年,在区域登记处对由所有≤2岁的常住儿童组成的动态队列进行了随访。每1,000人年RSV相关住院的人员发生率(IR)和严重住院的风险(ICU,C-PAP,或机械通气)计算每100例RSV住院。采用回顾性方法调查RSV季节性。
结果:总计,对193,244名儿童进行了随访。放宽限制后,与大流行前(2017年至2019年)相比,RSV疫情显示出更早的季节性和更短的持续时间,与此偏差在2022-2023年有所下降。在2021-2022年和2022-2023年,与大流行前相比,RSV相关住院的IR显着增加(2022-2023年风险比[RR]:3.6,95CI3.3-4.0),在老年群体中增加较大。在住院儿童中,只有年龄≥12个月的患者出现严重住院的风险增加,特别是在2021-2022年期间(RR4.7,95CI1.5-24.3)。
结论:研究结果表明,RSV的流行逐渐恢复到大流行前的模式,尽管相关的疾病发病率持续增加。年龄较大的儿童中常规RSV暴露的减少可能导致免疫力下降和严重的结果风险增加。
OBJECTIVE: to investigate seasonality, epidemiological characteristics, and clinical severity variations of RSV-associated hospitalizations following the easing of COVID-19 restrictions in Tuscany, Italy, up to the 2022-2023 season.
METHODS: from 2017 to 2023, a dynamic cohort consisting of all resident children aged ≤2 years was followed-up in regional registries. Person-time incidence rate(IR) of RSV-associated hospitalizations per 1,000 person-years and risk of severe hospitalization (ICU, C-PAP, or mechanical ventilation) per 100 RSV hospitalizations were calculated. RSV seasonality was investigated with retrospective methods.
RESULTS: in total, 193,244 children were followed-up. After the easing of restrictions, RSV epidemics showed earlier seasonality and shorter duration compared to pre-pandemic (2017 to 2019), with this deviation decreased in 2022-2023. In 2021-2022 and 2022-2023, the IR of RSV-associated hospitalizations significantly increased compared to pre-pandemic (2022-2023 risk ratio [RR]: 3.6, 95%CI 3.3-4.0), with larger increases among older age groups. Among hospitalized children, only those aged ≥12 months showed an increased risk of severe hospitalization, particularly during the 2021-2022 (RR 4.7, 95%CI 1.5-24.3).
CONCLUSIONS: findings suggest a gradual return of RSV epidemics to the pre-pandemic pattern, although relevant increases in disease incidence persist. Reduced regular RSV exposure among older children may lead to declining immunity and increased severe outcome risks.